Steerable laser probe and methods of use

ABSTRACT

A steerable laser probe may include a handle having a handle distal end and a handle proximal end, a housing sleeve disposed in an inner bore of the handle configured to project a distance from the handle distal end, an optic fiber disposed in the housing sleeve, a shape memory sleeve disposed over a distal end of the optic fiber, and a light source configured to connect to a proximal end of the optic fiber. The shape memory sleeve may be configured to curve the distal end of the optic fiber at an angle, e.g., 90 degrees, when the shape memory sleeve is not contained within the housing sleeve.

CROSS-REFERENCE TO RELATED APPLICATIONS

This Application is a continuation of prior application Ser. No.14/695,592 filed Apr. 24, 2015.

FIELD OF THE INVENTION

The present disclosure relates to a surgical instrument, and, moreparticularly, to a steerable laser probe.

BACKGROUND OF THE INVENTION

A wide variety of ophthalmic procedures require a laser energy source.For example, ophthalmic surgeons may use laser photocoagulation to treatproliferative retinopathy. Proliferative retinopathy is a conditioncharacterized by the development of abnormal blood vessels in the retinathat grow into the vitreous humor. Ophthalmic surgeons may treat thiscondition by energizing a laser to cauterize portions of the retina toprevent the abnormal blood vessels from growing and hemorrhaging.

In order to increase the chances of a successful laser photocoagulationprocedure, it is important that a surgeon is able aim the laser at aplurality of targets within the eye, e.g., by guiding or moving thelaser from a first target to a second target within the eye. It is alsoimportant that the surgeon is able to easily control a movement of thelaser. For example, the surgeon must be able to easily direct a laserbeam by steering the beam to a first position aimed at a first target,guide the laser beam from the first position to a second position aimedat a second target, and hold the laser beam in the second position.Accordingly, there is a need for a surgical laser probe that can beeasily guided to a plurality of targets within the eye.

BRIEF SUMMARY OF THE INVENTION

The present disclosure provides a steerable laser probe. In one or moreembodiments, a steerable laser probe may comprise a handle having ahandle distal end and a handle proximal end, a housing sleeve, an opticfiber disposed in the housing sleeve, a shape memory sleeve disposedover a distal end of the optic fiber, and a light source interfaceconfigured to interface with a proximal end of the optic fiber.Illustratively, the shape memory sleeve may be configured to hold thedistal end of the optic fiber at a pre-bent angle, e.g., 90 degrees,when the shape memory sleeve is not contained within the housing sleeve.

In one or more embodiments, a compression of an actuation structure ofthe handle actuates the housing sleeve relative to the shape memorysleeve and the optic fiber wherein the housing sleeve is graduallyextended over the shape memory sleeve and the optic fiber.Illustratively, the shape memory sleeve and the optic fiber aregradually straightened as the housing sleeve is gradually extended overthe shape memory sleeve and the optic fiber. In one or more embodiments,a decompression of the actuation structure actuates the housing sleeverelative to the shape memory sleeve and the optic fiber wherein thehousing sleeve is gradually retracted and the shape memory sleeve andthe optic fiber are gradually exposed by the housing sleeve.Illustratively, the shape memory sleeve gradually curves the optic fiberas the shape memory sleeve and the optic fiber are gradually exposed bythe housing sleeve.

In one or more embodiments, a compression of an actuation structure ofthe handle actuates the optic fiber and the shape memory sleeve relativeto the housing sleeve wherein the optic fiber and the shape memorysleeve are gradually extended from the housing sleeve. Illustratively,the shape memory sleeve and the optic fiber are gradually curved as theshape memory sleeve and the optic fiber are gradually extended from theshape memory sleeve. In one or more embodiments, a decompression of theactuation structure actuates the optic fiber and the shape memory sleeverelative to the housing sleeve wherein the optic fiber and the shapememory sleeve are gradually retracted into the housing sleeve.Illustratively, the housing sleeve gradually straightens the shapememory sleeve and the optic fiber as the shape memory sleeve and theoptic fiber are gradually retracted into the housing sleeve.

In one or more embodiments, a compression of an actuation structure ofthe handle actuates the optic fiber and the shape memory sleeve relativeto the housing sleeve wherein the optic fiber and the shape memorysleeve are gradually retracted into the housing sleeve. Illustratively,the shape memory sleeve and the optic fiber are gradually straightenedas the shape memory sleeve and the optic fiber are gradually retractedinto the housing sleeve. In one or more embodiments, a decompression ofthe actuation structure actuates the optic fiber and the shape memorysleeve relative to the housing sleeve wherein the optic fiber and theshape memory sleeve are gradually extended from the housing sleeve.Illustratively, the shape memory sleeve and the optic fiber aregradually curved as the shape memory sleeve and the optic fiber aregradually extended from the housing sleeve.

In one or more embodiments, a compression of an actuation structure ofthe handle actuates the housing sleeve relative to the optic fiber andthe shape memory sleeve wherein the housing sleeve is graduallyretracted to expose the optic fiber and the shape memory sleeve.Illustratively, the shape memory sleeve and the optic fiber aregradually curved as the shape memory sleeve and the optic fiber aregradually exposed by the housing sleeve. In one or more embodiments, adecompression of the actuation structure actuates the housing sleeverelative to the optic fiber and the shape memory sleeve wherein thehousing sleeve is gradually extended over the shape memory sleeve andthe optic fiber. Illustratively, the shape memory sleeve and the opticfiber are gradually straightened as the housing sleeve is graduallyextended over the shape memory sleeve and the optic fiber.

BRIEF DESCRIPTION OF THE DRAWINGS

The above and further advantages of the present invention may be betterunderstood by referring to the following description in conjunction withthe accompanying drawings in which like reference numerals indicateidentical or functionally similar elements:

FIGS. 1A and 1B are schematic diagrams illustrating a handle;

FIG. 2 illustrates an exploded view of a steerable laser probe assembly;

FIGS. 3A and 3B are schematic diagrams illustrating an assemblednosecone;

FIGS. 4A and 4B are schematic diagrams illustrating an assembledsteerable laser probe;

FIGS. 5A, 5B, and 5C are schematic diagrams illustrating a gradualcurving of an optic fiber;

FIGS. 6A, 6B, and 6C are schematic diagrams illustrating a gradualstraightening of an optic fiber;

FIGS. 7A and 7B are schematic diagrams illustrating a handle;

FIG. 8 illustrates an exploded view of a steerable laser probe assembly;

FIGS. 9A and 9B are schematic diagrams illustrating an assembledsteerable laser probe;

FIGS. 10A, 10B, and 10C are schematic diagrams illustrating a gradualcurving of an optic fiber;

FIGS. 11A, 11B, and 11C are schematic diagrams illustrating a gradualstraightening of an optic fiber;

FIGS. 12A and 12B are schematic diagrams illustrating a handle;

FIG. 13 illustrates an exploded view of a steerable laser probeassembly;

FIGS. 14A and 14B are schematic diagrams illustrating an assembledactuation mechanism;

FIGS. 15A and 15B are schematic diagrams illustrating an assembledsteerable laser probe;

FIGS. 16A, 16B, and 16C are schematic diagrams illustrating a gradualcurving of an optic fiber;

FIGS. 17A, 17B, and 17C are schematic diagrams illustrating a gradualstraightening of an optic fiber;

FIGS. 18A and 18B are schematic diagrams illustrating a handle;

FIG. 19 illustrates an exploded view of a steerable laser probeassembly;

FIGS. 20A and 20B are schematic diagrams illustrating an assembledsteerable laser probe;

FIGS. 21A, 21B, and 21C are schematic diagrams illustrating a gradualcurving of an optic fiber;

FIGS. 22A, 22B, and 22C are schematic diagrams illustrating a gradualstraightening of an optic fiber.

DETAILED DESCRIPTION OF AN ILLUSTRATIVE EMBODIMENT

FIGS. 1A and 1B are schematic diagrams illustrating a handle 100. FIG.1A illustrates a top view of handle 100. In one or more embodiments,handle 100 may comprise a handle distal end 101, a handle proximal end102, a handle base 110, and an actuation structure 120. Illustratively,actuation structure 120 may comprise a plurality of actuation arms 125.In one or more embodiments, actuation structure 120 may comprise a shapememory material. Actuation structure 120 may be manufactured from anysuitable material, e.g., polymers, metals, metal alloys, etc., or fromany combination of suitable materials.

Illustratively, actuation structure 120 may be compressed by anapplication of a compressive force to actuation structure 120. In one ormore embodiments, actuation structure 120 may be compressed by anapplication of one or more compressive forces located at one or morelocations around an outer perimeter of actuation structure 120.Illustratively, the one or more locations may comprise any of aplurality of locations around the outer perimeter of actuation structure120. For example, a surgeon may compress actuation structure 120 bysqueezing actuation structure 120. Illustratively, the surgeon maycompress actuation structure 120 by squeezing actuation structure 120 atany particular location of a plurality of locations around an outerperimeter of actuation structure 120. For example, a surgeon may rotatehandle 100 and compress actuation structure 120 from any rotationalposition of a plurality of rotational positions of handle 100.

In one or more embodiments, actuation structure 120 may be compressed byan application of a compressive force to any one or more of theplurality of actuation arms 125. Illustratively, each actuation arm 125may be configured to actuate independently. In one or more embodiments,each actuation arm 125 may be connected to one or more of the pluralityof actuation arms 125 wherein an actuation of a particular actuation arm125 may be configured to actuate every actuation arm 125 of theplurality of actuation arms 125. In one or more embodiments, acompression of actuation structure 120, e.g., due to an application of acompressive force to a particular actuation arm 125, may be configuredto actuate the particular actuation arm 125. Illustratively, anactuation of the particular actuation arm 125 may be configured toactuate every actuation arm 125 of the plurality of actuation arms 125.

FIG. 1B illustrates a cross-sectional view of handle 100. In one or moreembodiments, handle 100 may comprise an inner bore 140 and a fixationmechanism housing 150. Handle 100 may be manufactured from any suitablematerial, e.g., polymers, metals, metal alloys, etc., or from anycombination of suitable materials.

FIG. 2 illustrates an exploded view of a steerable laser probe assembly200. In one or more embodiments, steerable laser probe assembly 200 maycomprise a handle 100, a fixation mechanism 210, an actuation mechanism220 having an actuation mechanism distal end 221 and an actuationmechanism proximal end 222, a piston tube 225 having a piston tubedistal end 226 and a piston tube proximal end 227, a pressure mechanism230 having a pressure mechanism distal end 231 and a pressure mechanismproximal end 232, a nosecone 240 having a nosecone distal end 241 and anosecone proximal end 242, an actuation guide 245 having an actuationguide proximal end 247, a housing sleeve 250 having a housing sleevedistal end 251 and a housing sleeve proximal end 252, a shape memorysleeve 260 having a shape memory sleeve distal end 261 and a shapememory sleeve proximal end 262, an optic fiber 270 having an optic fiberdistal end 271 and an optic fiber proximal end 272, and a light sourceinterface 280. Illustratively, light source interface 280 may beconfigured to interface with optic fiber proximal end 272. In one ormore embodiments, light source interface 280 may comprise a standardlight source connecter, e.g., an SMA connector.

Illustratively, actuation mechanism 220 may comprise an actuation guideinterface 223 configured to interface with actuation guide 245. In oneor more embodiments, piston tube 225 may be fixed to actuation mechanismproximal end 222. Illustratively, actuation mechanism distal end 221 maybe fixed to housing sleeve proximal end 252. In one or more embodiments,actuation mechanism 220, piston tube 225, and housing sleeve 250 may bemanufactured as a unit. Illustratively, actuation guide 245 may be fixedan inner portion of nosecone 240. In one or more embodiments, actuationguide 245 and nosecone 240 may be manufactured as a unit.

FIGS. 3A and 3B are schematic diagrams illustrating an assemblednosecone 300. FIG. 3A illustrates a top view of assembled nosecone 300.Illustratively, actuation guide 245 may comprise an actuation channel310. FIG. 3B illustrates a cross-sectional view of assembled nosecone300. Illustratively, actuation guide 245 may comprise an actuation guideinner bore 320. In one or more embodiments, nosecone 240 may comprise anosecone inner chamber 330. Illustratively, nosecone inner chamber 330may comprise a pressure mechanism distal interface 331 and a noseconeinner chamber proximal opening 332. In one or more embodiments, noseconeinner chamber 330 may comprise an actuation mechanism distal interface335. Illustratively, nosecone 240 may comprise a housing sleeve guide340 configured to guide an actuation of housing sleeve 250.

FIGS. 4A and 4B are schematic diagrams illustrating an assembledsteerable laser probe 400. FIG. 4A illustrates a side view of anassembled steerable laser probe 400. Illustratively, optic fiber 270 maybe disposed within shape memory sleeve 260, e.g., optic fiber distal end271 may be adjacent to shape memory sleeve distal end 261. Optic fiber270 may be fixed in a position within shape memory sleeve 260, e.g., bya biocompatible adhesive or any other suitable fixation means. In one ormore embodiments, shape memory sleeve 260 may comprise a pre-bent angle265 configured to curve optic fiber 270 towards pre-bent angle 265.Illustratively, shape memory sleeve 260 may comprise a shape memorymaterial, e.g., nitinol, configured to steer optic fiber 270 towards oneor more surgical targets within an eye. Shape memory sleeve 260 may bemanufactured from any suitable material, e.g., polymers, metals, metalalloys, etc., or from any combination of suitable materials.

FIG. 4B illustrates a cross-sectional view of an assembled steerablelaser probe 400. Illustratively, pressure mechanism 230 may be disposedover actuation guide 245, e.g., pressure mechanism distal end 231 mayabut pressure mechanism distal interface 331. In one or moreembodiments, pressure mechanism 230 may be configured to provide aforce. Illustratively, pressure mechanism 230 may comprise a spring.Pressure mechanism 230 may be manufactured from any suitable material,e.g., polymers, metals, metal alloys, etc., or from any combination ofsuitable materials.

In one or more embodiments, housing sleeve 250 may be disposed withinactuation guide 245, nosecone 240, and housing sleeve guide 340, e.g.,housing sleeve distal end 251 may extend a distance from nosecone distalend 241. Illustratively, actuation guide 245 may be disposed withinactuation mechanism 220 and piston tube 225, e.g., actuation mechanismproximal end 247 may extend a distance from piston tube proximal end227. In one or more embodiments, actuation guide interface 223 may beconfigured to interface with actuation guide 245, e.g., when actuationguide 245 is disposed within actuation mechanism 220, actuation guideinterface 223 may be contained within actuation channel 310.Illustratively, pressure mechanism 230 may be disposed between actuationmechanism 220 and pressure mechanism distal interface 331, e.g.,pressure mechanism proximal end 232 may abut actuation mechanism distalend 221 and pressure mechanism distal end 231 may abut pressuremechanism distal interface 331.

In one or more embodiments, actuation guide 245 may be disposed withininner bore 140. Illustratively, piston tube 225 may be disposed withinactuation structure 120. In one or more embodiments, a portion ofactuation mechanism 220 may be disposed within actuation structure 120.Illustratively, optic fiber 270 and shape memory sleeve 260 may bedisposed within inner bore 140, actuation guide inner bore 320, pistontube 225, actuation mechanism 220, housing sleeve guide 340, and housingsleeve 250. In one or more embodiments, fixation mechanism 210 may beconfigured to fix optic fiber 270, shape memory sleeve 260, andactuation guide 245 in a position relative to handle 100. For example,fixation mechanism 210 may comprise a set screw configured to fix opticfiber 270, shape memory sleeve 260, and actuation guide 245 in aposition relative to handle 100, e.g., by an interference fit inactuation channel 310. In one or more embodiments, fixation mechanism210 may comprise an adhesive material configured to fix optic fiber 270,shape memory sleeve 260, and actuation guide 245 in a position relativeto handle 100, or fixation mechanism 210 may comprise one or moremagnets configured to fix optic fiber 270, shape memory sleeve 260, andactuation guide 245 in a position relative to handle 100.

Illustratively, a compression of actuation structure 120 may beconfigured to extend a portion of actuation mechanism 220 out ofactuation structure 120. For example, a compression of actuationstructure 120 may be configured to extend actuation mechanism 220relative to handle proximal end 102. In one or more embodiments, anapplication of a compressive force to one or more actuation arms 125 ofactuation structure 120 may be configured to extend actuation mechanism220 relative to handle proximal end 102, e.g., by advancing actuationmechanism 220 towards actuation mechanism distal interface 335. Forexample, a compression of actuation structure 120 may be configured toactuate actuation mechanism 220 along actuation mechanism guide 245. Inone or more embodiments, a compression of actuation structure 120 may beconfigured to advance actuation guide interface 223 within actuationchannel 310, e.g., away from actuation guide proximal end 247 andtowards actuation mechanism distal interface 335. Illustratively,pressure mechanism 230 may be configured to provide a resistive forcethat resists an extension of actuation mechanism 220 relative to handleproximal end 102.

In one or more embodiments, an extension of actuation mechanism 220 awayfrom handle proximal end 102 and towards actuation mechanism distalinterface 335, e.g., due to a compression of actuation structure 120,may be configured to extend housing sleeve 250 relative to shape memorysleeve 260 and optic fiber 270. Illustratively, a compression ofactuation structure 120 may be configured to actuate housing sleeve 250relative to shape memory sleeve 260 and optic fiber 270 wherein housingsleeve 250 may be gradually extended over shape memory sleeve 260 andoptic fiber 270. In one or more embodiments, shape memory sleeve 260 andoptic fiber 270 may be gradually straightened as housing sleeve 250 isgradually extended over shape memory sleeve 260 and optic fiber 270.

Illustratively, a decompression of actuation structure 120 may beconfigured to retract a portion of actuation mechanism 220 intoactuation structure 120. For example, a decompression of actuationstructure 120 may be configured to retract actuation mechanism 220relative to handle proximal end 102. In one or more embodiments, areduction of a compressive force applied to one or more actuation arms125 of actuation structure 120 may be configured to retract actuationmechanism 220 towards handle proximal end 102 and away from actuationmechanism distal interface 335. For example, a decompression ofactuation structure 120 may be configured to actuate actuation mechanism220 along actuation mechanism guide 245. In one or more embodiments, adecompression of actuation structure 120 may be configured to retractactuation guide interface 223 within actuation channel 310, e.g.,towards actuation guide proximal end 247 and away from actuationmechanism distal interface 335. Illustratively, pressure mechanism 230may be configured to provide a facilitating force that facilitates aretraction of actuation mechanism 220 relative to handle proximal end102.

In one or more embodiments, a retraction of actuation mechanism 220towards handle proximal end 102 and away from actuation mechanism distalinterface 335, e.g., due to a decompression of actuation structure 120,may be configured to retract housing sleeve 250 relative to shape memorysleeve 260 and optic fiber 270. Illustratively, a decompression ofactuation structure 120 may be configured to actuate housing sleeve 250relative to shape memory sleeve 260 and optic fiber 270 wherein housingsleeve 250 may be gradually retracted and shape memory sleeve 260 andoptic fiber 270 may be gradually exposed by housing sleeve 250. In oneor more embodiments, shape memory sleeve 260 may be configured togradually curve optic fiber 270, e.g., towards pre-bent angle 265, asshape memory sleeve 260 and optic fiber 270 are gradually exposed byhousing sleeve 250.

FIGS. 5A, 5B, and 5C are schematic diagrams illustrating a gradualcurving of an optic fiber 270. FIG. 5A illustrates a straightened opticfiber 500. Illustratively, straightened optic fiber 500 may be fullycontained within housing sleeve 250. In one or more embodiments, opticfiber 270 and shape memory sleeve 260 may be fully contained withinhousing sleeve 250, e.g., when actuation structure 120 is fullycompressed. For example, actuation mechanism distal end 221 may abutactuation mechanism distal interface 335, e.g., when optic fiber 270comprises a straightened optic fiber 500. Illustratively, when opticfiber 270 and shape memory sleeve 260 are fully contained within housingsleeve 250, pre-bent angle 265 of shape memory sleeve 260 may bestraightened by housing sleeve 250. For example, an angle betweenhousing sleeve 250 and a line tangent to optic fiber distal end 271 maybe, e.g., 180 degrees, when housing sleeve 250 contains a straightenedoptic fiber 500.

FIG. 5B illustrates a partially curved optic fiber 510. In one or moreembodiments, a decompression of a fully compressed actuation structure120 may be configured to gradually retract housing sleeve 250, e.g., toexpose optic fiber 270 and shape memory sleeve 260. Illustratively, asoptic fiber 270 and shape memory sleeve 260 are gradually exposed by aretraction of housing sleeve 250, shape memory sleeve 260 may beconfigured to cause optic fiber 270 to gradually curve toward pre-bentangle 265. In one or more embodiments, a decompression of actuationstructure 120 may be configured to cause a straightened optic fiber 500to gradually curve to a partially curved optic fiber 510.Illustratively, a decompression of actuation structure 120 may beconfigured to gradually expose optic fiber 270 and shape memory sleeve260 causing optic fiber 270 to gradually curve toward pre-bent angle265. For example, as an exposed length of optic fiber 270 and shapememory sleeve 260 is increased, e.g., by a retraction of housing sleeve250, an angle between housing sleeve 250 and a line tangent to opticfiber distal end 271 may be decreased.

Illustratively, optic fiber 270 and shape memory sleeve 260 may beexposed from housing sleeve distal end 251 at a first exposed lengthwith a first angle between housing sleeve 250 and a line tangent tooptic fiber distal end 271. A retraction of housing sleeve 250, e.g.,due to a decompression of actuation structure 120, may be configured toexpose optic fiber 270 and shape memory sleeve 260 from housing sleevedistal end 251 at a second exposed length with a second angle betweenhousing sleeve 250 and a line tangent to optic fiber distal end 271.Illustratively, the second exposed length may be greater than the firstexposed length and the second angle may be less than the first angle.

FIG. 5C illustrates a fully curved optic fiber 520. Illustratively, whenhousing sleeve 250 is fully retracted, e.g., by a full decompression ofactuation structure 120, housing sleeve 250 may expose a fully curvedoptic fiber 520. In one or more embodiments, a decompression ofactuation structure 120 may be configured to cause a partially curvedoptic fiber 510 to gradually curve to a fully curved optic fiber 520.

Illustratively, when housing sleeve 250 is retracted to expose apartially curved optic fiber 510, optic fiber 270 and shape memorysleeve 260 may be exposed from housing sleeve distal end 251 at apartially exposed length with a partially exposed angle between housingsleeve 250 and a line tangent to optic fiber distal end 271. Aretraction of housing sleeve 250, e.g., due to a full decompression ofactuation structure 120, may be configured to expose optic fiber 270 andshape memory sleeve 260 from housing sleeve distal end 251 at fullyexposed length with a fully exposed angle between housing sleeve 250 anda line tangent to optic fiber distal end 271. For example, housingsleeve 250 may expose optic fiber 270 and shape memory sleeve 260 at afully exposed length with a fully exposed angle between housing sleeve250 and a line tangent to optic fiber distal end 271 when housing sleeve250 is retracted to expose a fully curved optic fiber 520.Illustratively, the fully exposed length may be greater than thepartially exposed length and the fully exposed angle may be less thanthe partially exposed angle.

In one or more embodiments, one or more properties of a steerable laserprobe may be adjusted to attain one or more desired steerable laserprobe features. Illustratively, a position of fixation mechanism housing150 and fixation mechanism 210 or a length of optic fiber 270 and shapememory sleeve 260 extending distally from a position of fixationmechanism 210 may be adjusted to vary an amount of decompression ofactuation structure 120 configured to expose a particular length ofoptic fiber 270 and shape memory sleeve 260 from housing sleeve distalend 251. In one or more embodiments, one or more properties of pressuremechanism 230 may be adjusted to attain one or more desired steerablelaser probe features. Illustratively, a spring constant of pressuremechanism 230 may be adjusted to vary an amount of decompression ofactuation structure 120 configured to expose a particular length ofoptic fiber 270 and shape memory sleeve 260 from housing sleeve distalend 251. In one or more embodiments, a geometry of actuation mechanism220 may be adjusted to vary an amount of decompression of actuationstructure 120 configured to expose a particular length of optic fiber270 and shape memory sleeve 260 from housing sleeve distal end 251.Illustratively, a length of housing sleeve 250 may be adjusted to varyan amount of decompression of actuation structure 120 configured toexpose a particular length of optic fiber 270 and shape memory sleeve260 from housing sleeve distal end 251. In one or more embodiments, ageometry of actuation structure 120 may be adjusted to vary an amount ofdecompression of actuation structure 120 configured to expose aparticular length of optic fiber 270 and shape memory sleeve 260 fromhousing sleeve distal end 251. Illustratively, a magnitude of pre-bentangle 265 may be adjusted to vary a magnitude of an angle betweenhousing sleeve 250 and a line tangent to optic fiber distal end 271 whena particular length of optic fiber 270 and shape memory sleeve 260 isexposed from housing sleeve distal end 251.

In one or more embodiments, one or more properties of optic fiber 270may be adjusted to attain one or more steerable laser probe features.For example, a portion of optic fiber 270 may be formed in a pre-bentangle. Illustratively, a portion of optic fiber 270 may be formed in apre-bent angle by, e.g., heating the portion of optic fiber 270 to atemperature configured to weaken chemical bonds of the portion of opticfiber 270, molding the portion of optic fiber 270 in a pre-bent angle,and cooling the portion of optic fiber 270. In one or more embodiments,optic fiber 270 may be coated by a buffer material. Illustratively, thebuffer material may comprise a fluoropolymer, e.g., Teflon, Tefzel, etc.In one or more embodiments, a portion of optic fiber 270 may be formedin a pre-bent angle by, e.g., heating the buffer material to atemperature configured to weaken chemical bonds of the buffer material,molding the portion of optic fiber 270 in a pre-bent angle, and coolingthe buffer material. Illustratively, housing sleeve 250 may beconfigured to hold a pre-bent angle of optic fiber 270 in a straightenedposition, e.g., when optic fiber 270 is fully contained within housingsleeve 250. In one or more embodiments, a decompression of actuationstructure 120 may be configured to retract housing sleeve 250 relativeto optic fiber 270 causing optic fiber 270 to gradually curve towardsthe pre-bent angle as optic fiber 270 is gradually exposed by housingsleeve 250.

FIGS. 6A, 6B, and 6C are schematic diagrams illustrating a gradualstraightening of an optic fiber 270. FIG. 6A illustrates a retractedhousing sleeve 600. Illustratively, a retracted housing sleeve 600 mayexpose at least a portion of optic fiber 270 and shape memory sleeve 260from housing sleeve distal end 251. In one or more embodiments, a fulldecompression of actuation structure 120 may be configured to causehousing sleeve 250 to be retracted relative to optic fiber 270 and shapememory sleeve 260 wherein a fully curved optic fiber 520 may be exposedfrom housing sleeve distal end 251. Illustratively, housing sleeve 250may comprise a retracted housing sleeve 600, e.g., due to a fulldecompression of actuation structure 120.

FIG. 6B illustrates a partially extended housing sleeve 610.Illustratively, a partially extended housing sleeve 610 may hold aportion of pre-bent angle 265 in a straightened position within housingsleeve 250. In one or more embodiments, a compression of actuationstructure 120 may be configured to extend housing sleeve 250 over opticfiber 270 and shape memory sleeve 260 causing shape memory sleeve 260 togradually straighten optic fiber 270 from a fully curved optic fiber 520to a partially curved optic fiber 510.

FIG. 6C illustrates a fully extended housing sleeve 620. Illustratively,a fully extended housing sleeve 620 may hold pre-bent angle 265 in astraightened position within housing sleeve 250. In one or moreembodiments, a full compression of actuation structure 120 may beconfigured to extend housing sleeve 250 over optic fiber 270 and shapememory sleeve 260 causing shape memory sleeve 260 to graduallystraighten optic fiber 270 from a partially curved optic fiber 510 to astraightened optic fiber 500.

Illustratively, a surgeon may aim optic fiber distal end 271 at any of aplurality of targets within an eye, e.g., to perform a photocoagulationprocedure. In one or more embodiments, a surgeon may aim optic fiberdistal end 271 at any target within a particular transverse plane of theinner eye by, e.g., rotating handle 100 to orient shape memory sleeve260 in an orientation configured to cause a curvature of optic fiber 270within the particular transverse plane of the inner eye and varying anamount of compression of actuation structure 120. Illustratively, asurgeon may aim optic fiber distal end 271 at any target within aparticular sagittal plane of the inner eye by, e.g., rotating handle 100to orient shape memory sleeve 260 in an orientation configured to causea curvature of optic fiber 270 within the particular sagittal plane ofthe inner eye and varying an amount of compression of actuationstructure 120. In one or more embodiments, a surgeon may aim optic fiberdistal end 271 at any target within a particular frontal plane of theinner eye by, e.g., varying an amount of compression of actuationstructure 120 to orient a line tangent to optic fiber distal end 271wherein the line tangent to optic fiber distal end 271 is within theparticular frontal plane of the inner eye and rotating handle 100.Illustratively, a surgeon may aim optic fiber distal end 271 at anytarget located outside of the particular transverse plane, theparticular sagittal plane, and the particular frontal plane of the innereye, e.g., by varying a rotational orientation of handle 100 and varyingan amount of compression of actuation structure 120.

FIGS. 7A and 7B are schematic diagrams illustrating a handle 700. FIG.7A illustrates a top view of handle 700. In one or more embodiments,handle 700 may comprise a handle distal end 701, a handle proximal end702, a handle base 710, and an actuation structure 720. Illustratively,actuation structure 720 may comprise a plurality of actuation arms 725.In one or more embodiments, actuation structure 720 may comprise a shapememory material. Actuation structure 720 may be manufactured from anysuitable material, e.g., polymers, metals, metal alloys, etc., or fromany combination of suitable materials.

Illustratively, actuation structure 720 may be compressed by anapplication of a compressive force to actuation structure 720. In one ormore embodiments, actuation structure 720 may be compressed by anapplication of one or more compressive forces located at one or morelocations around an outer perimeter of actuation structure 720.Illustratively, the one or more locations may comprise any of aplurality of locations around the outer perimeter of actuation structure720. For example, a surgeon may compress actuation structure 720 bysqueezing actuation structure 720. Illustratively, the surgeon maycompress actuation structure 720 by squeezing actuation structure 720 atany particular location of a plurality of locations around an outerperimeter of actuation structure 720. For example, a surgeon may rotatehandle 700 and compress actuation structure 720 from any rotationalposition of a plurality of rotational positions of handle 700.

In one or more embodiments, actuation structure 720 may be compressed byan application of a compressive force to any one or more of theplurality of actuation arms 725. Illustratively, each actuation arm 725may be configured to actuate independently. In one or more embodiments,each actuation arm 725 may be connected to one or more of the pluralityof actuation arms 725 wherein an actuation of a particular actuation arm725 may be configured to actuate every actuation arm 725 of theplurality of actuation arms 725. In one or more embodiments, acompression of actuation structure 720, e.g., due to an application of acompressive force to a particular actuation arm 725, may be configuredto actuate the particular actuation arm 725. Illustratively, anactuation of the particular actuation arm 725 may be configured toactuate every actuation arm 725 of the plurality of actuation arms 725.

FIG. 7B illustrates a cross-sectional view of handle 700. In one or moreembodiments, handle 700 may comprise an inner bore 740 and a fixationmechanism housing 750. Handle 700 may be manufactured from any suitablematerial, e.g., polymers, metals, metal alloys, etc., or from anycombination of suitable materials.

FIG. 8 illustrates an exploded view of a steerable laser probe assembly800. In one or more embodiments, steerable laser probe assembly 800 maycomprise a handle 700, a fixation mechanism 810, an actuation mechanism220 having an actuation mechanism distal end 221 and an actuationmechanism proximal end 222, a piston tube 225 having a piston tubedistal end 226 and a piston tube proximal end 227, a pressure mechanism230 having a pressure mechanism distal end 231 and a pressure mechanismproximal end 232, a nosecone 240 having a nosecone distal end 241 and anosecone proximal end 242, an actuation guide 245 having an actuationguide proximal end 247, a housing sleeve 250 having a housing sleevedistal end 251 and a housing sleeve proximal end 252, a shape memorysleeve 260 having a shape memory sleeve distal end 261 and a shapememory sleeve proximal end 262, an optic fiber 270 having an optic fiberdistal end 271 and an optic fiber proximal end 272, and a light sourceinterface 280. Illustratively, light source interface 280 may beconfigured to interface with optic fiber proximal end 272. In one ormore embodiments, light source interface 280 may comprise a standardlight source connecter, e.g., an SMA connector.

Illustratively, actuation mechanism 220 may comprise an actuation guideinterface 820 configured to interface with actuation guide 245. In oneor more embodiments, piston tube 225 may be fixed to actuation mechanismproximal end 222. Illustratively, actuation mechanism 220 and pistontube 225 may be manufactured as a unit. In one or more embodiments,housing tube proximal end 252 may be fixed to nosecone proximal end 241.Illustratively, actuation guide 245 may be fixed an inner portion ofnosecone 240. In one or more embodiments, actuation guide 245, nosecone240, and housing sleeve 250 may be manufactured as a unit.

FIGS. 9A and 9B are schematic diagrams illustrating an assembledsteerable laser probe 900. FIG. 9A illustrates a side view of anassembled steerable laser probe 900. Illustratively, optic fiber 270 maybe disposed within shape memory sleeve 260, e.g., optic fiber distal end271 may be adjacent to shape memory sleeve distal end 261. Optic fiber270 may be fixed in a position within shape memory sleeve 260, e.g., bya biocompatible adhesive or any other suitable fixation means. In one ormore embodiments, shape memory sleeve 260 may comprise a pre-bent angle265 configured to curve optic fiber 270 towards pre-bent angle 265.Illustratively, shape memory sleeve 260 may comprise a shape memorymaterial, e.g., nitinol, configured to steer optic fiber 270 towards oneor more surgical targets within an eye. Shape memory sleeve 260 may bemanufactured from any suitable material, e.g., polymers, metals, metalalloys, etc., or from any combination of suitable materials.

FIG. 9B illustrates a cross-sectional view of an assembled steerablelaser probe 900. Illustratively, pressure mechanism 230 may be disposedover actuation guide 245, e.g., pressure mechanism distal end 231 mayabut pressure mechanism distal interface 331. In one or moreembodiments, pressure mechanism 230 may be configured to provide aforce. Illustratively, pressure mechanism 230 may comprise a spring.Pressure mechanism 230 may be manufactured from any suitable material,e.g., polymers, metals, metal alloys, etc., or from any combination ofsuitable materials.

Illustratively, actuation guide 245 may be disposed within actuationmechanism 220 and piston tube 225, e.g., actuation mechanism proximalend 247 may extend a distance from piston tube proximal end 227. In oneor more embodiments, actuation guide interface 820 may be configured tointerface with actuation guide 245, e.g., when actuation guide 245 isdisposed within actuation mechanism 220, actuation guide interface 820may be contained within actuation channel 310. Illustratively, pressuremechanism 230 may be disposed between actuation mechanism 220 andpressure mechanism distal interface 331, e.g., pressure mechanismproximal end 232 may abut actuation mechanism distal end 221 andpressure mechanism distal end 231 may abut pressure mechanism distalinterface 331.

In one or more embodiments, actuation guide 245 may be disposed withininner bore 740. Illustratively, piston tube 225 may be disposed withinactuation structure 720. In one or more embodiments, a portion ofactuation mechanism 220 may be disposed within actuation structure 720.Illustratively, optic fiber 270 and shape memory sleeve 260 may bedisposed within inner bore 740, actuation guide inner bore 320, pistontube 225, actuation mechanism 220, housing sleeve guide 340, and housingsleeve 250. In one or more embodiments, optic fiber 270 and shape memorysleeve 260 may be fixed to an inner portion of actuation mechanism 220.For example, shape memory sleeve 260 may be fixed within actuationmechanism 220 by an adhesive or by any suitable fixation means.Illustratively, an actuation of actuation mechanism 220 may beconfigured to actuate optic fiber 270 and shape memory sleeve 260.

In one or more embodiments, fixation mechanism 810 may be configured tofix actuation guide 245 in a position relative to handle 700. Forexample, fixation mechanism 810 may comprise a set screw configured tofix actuation guide 245 in a position relative to handle 700, e.g., byan interference fit in actuation channel 310. In one or moreembodiments, fixation mechanism 810 may comprise an adhesive materialconfigured to fix actuation guide 245 in a position relative to handle700, or fixation mechanism 810 may comprise one or more magnetsconfigured to fix actuation guide 245 in a position relative to handle700.

Illustratively, a compression of actuation structure 720 may beconfigured to extend a portion of actuation mechanism 220 out ofactuation structure 720. For example, a compression of actuationstructure 720 may be configured to extend actuation mechanism 220relative to handle proximal end 702. In one or more embodiments, anapplication of a compressive force to one or more actuation arms 725 ofactuation structure 720 may be configured to extend actuation mechanism220 relative to handle proximal end 702, e.g., by advancing actuationmechanism 220 towards actuation mechanism distal interface 335. Forexample, a compression of actuation structure 720 may be configured toactuate actuation mechanism 220 along actuation mechanism guide 245. Inone or more embodiments, a compression of actuation structure 720 may beconfigured to advance actuation guide interface 820 within actuationchannel 310, e.g., away from actuation guide proximal end 247 andtowards actuation mechanism distal interface 335. Illustratively,pressure mechanism 230 may be configured to provide a resistive forcethat resists an extension of actuation mechanism 220 relative to handleproximal end 702.

In one or more embodiments, an extension of actuation mechanism 220 awayfrom handle proximal end 702 and towards actuation mechanism distalinterface 335, e.g., due to a compression of actuation structure 720,may be configured to extend shape memory sleeve 260 and optic fiber 270relative to housing sleeve 250. Illustratively, a compression ofactuation structure 720 may be configured to actuate shape memory sleeve260 and optic fiber 270 relative to housing sleeve 250 wherein shapememory sleeve 260 and optic fiber 270 may be gradually extended fromhousing sleeve 250. For example, a compression of actuation structure720 may be configured to gradually extend shape memory sleeve 260 andoptic fiber 270 from housing sleeve distal end 251. In one or moreembodiments, shape memory sleeve 260 may be configured to graduallycurve optic fiber 270, e.g., towards pre-bent angle 265, as shape memorysleeve 260 and optic fiber 270 are gradually extended from housingsleeve distal end 251.

is Illustratively, a decompression of actuation structure 720 may beconfigured to retract a portion of actuation mechanism 220 intoactuation structure 720. For example, a decompression of actuationstructure 720 may be configured to retract actuation mechanism 220relative to handle proximal end 702. In one or more embodiments, areduction of a compressive force applied to one or more actuation arms725 of actuation structure 720 may be configured to retract actuationmechanism 220 towards handle proximal end 702 and away from actuationmechanism distal interface 335. For example, a decompression ofactuation structure 720 may be configured to actuate actuation mechanism220 along actuation mechanism guide 245. In one or more embodiments, adecompression of actuation structure 720 may be configured to retractactuation guide interface 820 within actuation channel 310, e.g.,towards actuation guide proximal end 247 and away from actuationmechanism distal interface 335. Illustratively, pressure mechanism 230may be configured to provide a facilitating force that facilitates aretraction of actuation mechanism 220 relative to handle proximal end702.

In one or more embodiments, a retraction of actuation mechanism 220towards handle proximal end 702 and away from actuation mechanism distalinterface 335, e.g., due to a decompression of actuation structure 720,may be configured to retract shape memory sleeve 260 and optic fiber 270relative to housing sleeve 250. Illustratively, a decompression ofactuation structure 720 may be configured to actuate shape memory sleeve260 and optic fiber 270 relative to housing sleeve 250 wherein shapememory sleeve 260 and optic fiber 270 may be gradually retracted intohousing sleeve 250. For example, a decompression of actuation structure720 may be configured to retract shape memory sleeve 260 and optic fiber270 into housing sleeve distal end 251. In one or more embodiments,shape memory sleeve 260 and optic fiber 270 may be graduallystraightened as shape memory sleeve 260 and optic fiber 270 aregradually retracted into housing sleeve 250.

FIGS. 10A, 10B, and 10C are schematic diagrams illustrating a gradualcurving of an optic fiber 270. FIG. 10A illustrates a straightened opticfiber 1000. Illustratively, straightened optic fiber 1000 may be fullycontained within housing sleeve 250. In one or more embodiments, opticfiber 270 and shape memory sleeve 260 may be fully contained withinhousing sleeve 250, e.g., when actuation structure 720 is fullydecompressed. For example, actuation mechanism 220 may be fullyretracted, e.g., when optic fiber 270 comprises a straightened opticfiber 1000. Illustratively, when optic fiber 270 and shape memory sleeve260 are fully contained within housing sleeve 250, pre-bent angle 265 ofshape memory sleeve 260 may be straightened by housing sleeve 250. Forexample, an angle between housing sleeve 250 and a line tangent to opticfiber distal end 271 may be, e.g., 180 degrees, when housing sleeve 250contains a straightened optic fiber 1000.

FIG. 10B illustrates a partially curved optic fiber 1010. In one or moreembodiments, a compression of a fully decompressed actuation structure720 may be configured to gradually extend optic fiber 270 and shapememory sleeve 260 from housing sleeve distal end 251. Illustratively, asoptic fiber 270 and shape memory sleeve 260 are gradually extended fromhousing sleeve distal end 251, shape memory sleeve 260 may be configuredto cause optic fiber 270 to gradually curve toward pre-bent angle 265.In one or more embodiments, a compression of actuation structure 720 maybe configured to cause a straightened optic fiber 1000 to graduallycurve to a partially curved optic fiber 1010. Illustratively, acompression of actuation structure 720 may be configured to graduallyextend optic fiber 270 and shape memory sleeve 260 from housing sleeve250 causing optic fiber 270 to gradually curve toward pre-bent angle265. For example, as an extended length of optic fiber 270 and shapememory sleeve 260 is increased, e.g., by an extension of optic fiber 270and shape memory sleeve 260 from housing sleeve distal end 251, an anglebetween housing sleeve 250 and a line tangent to optic fiber distal end271 may be decreased.

Illustratively, optic fiber 270 and shape memory sleeve 260 may beextended from housing sleeve distal end 251 at a first extended lengthwith a first angle between housing sleeve 250 and a line tangent tooptic fiber distal end 271. An extension of optic fiber 270 and shapememory sleeve 260 from housing sleeve 250, e.g., due to a compression ofactuation structure 720, may be configured to extend optic fiber 270 andshape memory sleeve 260 from housing sleeve distal end 251 at a secondextended length with a second angle between housing sleeve 250 and aline tangent to optic fiber distal end 271. Illustratively, the secondextended length may be greater than the first extended length and thesecond angle may be less than the first angle.

FIG. 10C illustrates a fully curved optic fiber 1020. Illustratively,when optic fiber 270 and shape memory sleeve 260 are fully extended fromhousing sleeve 250, e.g., by a full compression of actuation structure720, optic fiber 270 may comprise a fully curved optic fiber 1020. Inone or more embodiments, a compression of actuation structure 720 may beconfigured to cause a partially curved optic fiber 1010 to graduallycurve to a fully curved optic fiber 1020.

Illustratively, when optic fiber 270 and shape memory sleeve 260 areextended from housing sleeve 250 wherein optic fiber may comprise apartially curved optic fiber 1010, optic fiber 270 and shape memorysleeve 260 may be extended from housing sleeve distal end 251 at apartially extended length with a partially extended angle betweenhousing sleeve 250 and a line tangent to optic fiber distal end 271. Anextension of optic fiber 270 and shape memory sleeve 260 from housingsleeve 250, e.g., due to a full compression of actuation structure 720,may be configured to extend optic fiber 270 and shape memory sleeve 260from housing sleeve distal end 251 at fully extended length with a fullyextended angle between housing sleeve 250 and a line tangent to opticfiber distal end 271. For example, optic fiber 270 and shape memorysleeve 260 may be extended from housing sleeve distal end 251 at a fullyextended length with a fully extended angle between housing sleeve 250and a line tangent to optic fiber distal end 271 when optic fiber 270comprises a fully curved optic fiber 1020. Illustratively, the fullyextended length may be greater than the partially extended length andthe fully extended angle may be less than the partially extended angle.

In one or more embodiments, one or more properties of a steerable laserprobe may be adjusted to attain one or more desired steerable laserprobe features. Illustratively, a position of fixation mechanism housing750 and fixation mechanism 810 or a length of optic fiber 270 and shapememory sleeve 260 extending distally from a position of fixationmechanism 810 may be adjusted to vary an amount of compression ofactuation structure 720 configured to extend a particular length ofoptic fiber 270 and shape memory sleeve 260 from housing sleeve distalend 251. In one or more embodiments, one or more properties of pressuremechanism 230 may be adjusted to attain one or more desired steerablelaser probe features. Illustratively, a spring constant of pressuremechanism 230 may be adjusted to vary an amount of compression ofactuation structure 720 configured to extend a particular length ofoptic fiber 270 and shape memory sleeve 260 from housing sleeve distalend 251. In one or more embodiments, a geometry of actuation mechanism220 may be adjusted to vary an amount of compression of actuationstructure 720 configured to extend a particular length of optic fiber270 and shape memory sleeve 260 from housing sleeve distal end 251.Illustratively, a length of housing sleeve 250 may be adjusted to varyan amount of compression of actuation structure 720 configured to extenda particular length of optic fiber 270 and shape memory sleeve 260 fromhousing sleeve distal end 251. In one or more embodiments, a geometry ofactuation structure 720 may be adjusted to vary an amount of compressionof actuation structure 720 configured to extend a particular length ofoptic fiber 270 and shape memory sleeve 260 from housing sleeve distalend 251. Illustratively, a magnitude of pre-bent angle 265 may beadjusted to vary a magnitude of an angle between housing sleeve 250 anda line tangent to optic fiber distal end 271 when a particular length ofoptic fiber 270 and shape memory sleeve 260 is extended from housingsleeve distal end 251.

In one or more embodiments, one or more properties of optic fiber 270may be adjusted to attain one or more steerable laser probe features.For example, a portion of optic fiber 270 may be formed in a pre-bentangle. Illustratively, a portion of optic fiber 270 may be formed in apre-bent angle by, e.g., heating the portion of optic fiber 270 to atemperature configured to weaken chemical bonds of the portion of opticfiber 270, molding the portion of optic fiber 270 in a pre-bent angle,and cooling the portion of optic fiber 270. In one or more embodiments,optic fiber 270 may be coated by a buffer material. Illustratively, thebuffer material may comprise a fluoropolymer, e.g., Teflon, Tefzel, etc.In one or more embodiments, a portion of optic fiber 270 may be formedin a pre-bent angle by, e.g., heating the buffer material to atemperature configured to weaken chemical bonds of the buffer material,molding the portion of optic fiber 270 in a pre-bent angle, and coolingthe buffer material. Illustratively, housing sleeve 250 may beconfigured to hold a pre-bent angle of optic fiber 270 in a straightenedposition, e.g., when optic fiber 270 is fully contained within housingsleeve 250. In one or more embodiments, a compression of actuationstructure 720 may be configured to extend optic fiber 270 relative tohousing sleeve 250 causing optic fiber 270 to gradually curve towardsthe pre-bent angle as optic fiber 270 is gradually extended from housingsleeve distal end 251.

FIGS. 11A, 11B, and 11C are schematic diagrams illustrating a gradualstraightening of an optic fiber 270. FIG. 11A illustrates an extendedoptic fiber 1100. Illustratively, optic fiber 270 may comprise anextended optic fiber 1100 when at least a portion of optic fiber 270 andshape memory sleeve 260 are extended from housing sleeve distal end 251.In one or more embodiments, a full compression of actuation structure720 may be configured to extend optic fiber 270 and shape memory sleeve260 from housing sleeve distal end 250 wherein optic fiber 270 maycomprise a fully curved optic fiber 1020. Illustratively, optic fiber270 may comprise an extended optic fiber 1100, e.g., due to a fullcompression of actuation structure 720.

FIG. 11B illustrates a partially retracted optic fiber 1110.Illustratively, housing sleeve 250 may be configured to hold a portionof pre-bent angle 265 in a straightened position within housing sleeve250, e.g., when optic fiber 270 comprises a partially retracted opticfiber 1110. In one or more embodiments, a decompression of actuationstructure 720 may be configured to retract optic fiber 270 and shapememory sleeve 260 into housing sleeve 250 wherein shape memory sleeve260 may be configured to gradually straighten optic fiber 270 from afully curved optic fiber 1020 to a partially curved optic fiber 1010.

FIG. 11C illustrates a fully retracted optic fiber 1120. Illustratively,housing sleeve 250 may be configured to hold pre-bent angle 265 in astraightened position within housing sleeve 250, e.g., when optic fiber270 comprises a fully retracted optic fiber 1120. In one or moreembodiments, a full decompression of actuation structure 720 may beconfigured to retract optic fiber 270 and shape memory sleeve 260 intohousing sleeve 250 wherein shape memory sleeve 260 may be configured togradually straighten optic fiber 270 from a partially curved optic fiber1010 to a straightened optic fiber 1000.

Illustratively, a surgeon may aim optic fiber distal end 271 at any of aplurality of targets within an eye, e.g., to perform a photocoagulationprocedure. In one or more embodiments, a surgeon may aim optic fiberdistal end 271 at any target within a particular transverse plane of theinner eye by, e.g., rotating handle 700 to orient shape memory sleeve260 in an orientation configured to cause a curvature of optic fiber 270within the particular transverse plane of the inner eye and varying anamount of compression of actuation structure 720. Illustratively, asurgeon may aim optic fiber distal end 271 at any target within aparticular sagittal plane of the inner eye by, e.g., rotating handle 700to orient shape memory sleeve 260 in an orientation configured to causea curvature of optic fiber 270 within the particular sagittal plane ofthe inner eye and varying an amount of compression of actuationstructure 720. In one or more embodiments, a surgeon may aim optic fiberdistal end 271 at any target within a particular frontal plane of theinner eye by, e.g., varying an amount of compression of actuationstructure 720 to orient a line tangent to optic fiber distal end 271wherein the line tangent to optic fiber distal end 271 is within theparticular frontal plane of the inner eye and rotating handle 700.Illustratively, a surgeon may aim optic fiber distal end 271 at anytarget located outside of the particular transverse plane, theparticular sagittal plane, and the particular frontal plane of the innereye, e.g., by varying a rotational orientation of handle 700 and varyingan amount of compression of actuation structure 720.

FIGS. 12A and 12B are schematic diagrams illustrating a handle 1200.FIG. 12A illustrates a top view of handle 1200. In one or moreembodiments, handle 1200 may comprise a handle distal end 1201, a handleproximal end 1202, a handle base 1210, and an actuation structure 1220.Illustratively, actuation structure 1220 may comprise a plurality ofactuation arms 1225. In one or more embodiments, actuation structure1220 may comprise a shape memory material. Actuation structure 1220 maybe manufactured from any suitable material, e.g., polymers, metals,metal alloys, etc., or from any combination of suitable materials.

Illustratively, actuation structure 1220 may be compressed by anapplication of a compressive force to actuation structure 1220. In oneor more embodiments, actuation structure 1220 may be compressed by anapplication of one or more compressive forces located at one or morelocations around an outer perimeter of actuation structure 1220.Illustratively, the one or more locations may comprise any of aplurality of locations around the outer perimeter of actuation structure1220. For example, a surgeon may com-press actuation structure 1220 bysqueezing actuation structure 1220. Illustratively, the surgeon maycompress actuation structure 1220 by squeezing actuation structure 1220at any particular location of a plurality of locations around an outerperimeter of actuation structure 1220. For example, a surgeon may rotatehandle 1200 and compress actuation structure 1220 from any rotationalposition of a plurality of rotational positions of handle 1200.

In one or more embodiments, actuation structure 1220 may be compressedby an application of a compressive force to any one or more of theplurality of actuation arms 1225. Illustratively, each actuation arm1225 may be configured to actuate independently. In one or moreembodiments, each actuation arm 1225 may be connected to one or more ofthe plurality of actuation arms 1225 wherein an actuation of aparticular actuation arm 1225 may be configured to actuate everyactuation arm 1225 of the plurality of actuation arms 1225. In one ormore embodiments, a compression of actuation structure 1220, e.g., dueto an application of a compressive force to a particular actuation arm1225, may be configured to actuate the particular actuation arm 1225.Illustratively, an actuation of the particular actuation arm 1225 may beconfigured to actuate every actuation arm 1225 of the plurality ofactuation arms 1225.

FIG. 12B illustrates a cross-sectional view of handle 1200. In one ormore embodiments, handle 1200 may comprise an inner bore 1240, afixation mechanism housing 1250, and a pressure mechanism proximalinterface 1260. Handle 1200 may be manufactured from any suitablematerial, e.g., polymers, metals, metal alloys, etc., or from anycombination of suitable materials.

FIG. 13 illustrates an exploded view of a steerable laser probe assembly1300. In one or more embodiments, steerable laser probe assembly 1300may comprise a handle 1200, a fixation mechanism 1310, an actuationmechanism 1320 having an actuation mechanism distal end 1321 and anactuation mechanism proximal end 1322, a piston tube 1325 having apiston tube distal end 1326 and a piston tube proximal end 1327, apressure mechanism 1330 having a pressure mechanism distal end 1331 anda pressure mechanism proximal end 1332, a nosecone 240 having a noseconedistal end 241 and a nosecone proximal end 242, an actuation guide 245having an actuation guide proximal end 247, a housing sleeve 250 havinga housing sleeve distal end 251 and a housing sleeve proximal end 252, ashape memory sleeve 260 having a shape memory sleeve distal end 261 anda shape memory sleeve proximal end 262, an optic fiber 270 having anoptic fiber distal end 271 and an optic fiber proximal end 272, and alight source interface 280. Illustratively, light source interface 280may be configured to interface with optic fiber proximal end 272. In oneor more embodiments, light source interface 280 may comprise a standardlight source connecter, e.g., an SMA connector.

Illustratively, actuation mechanism 1320 may comprise an actuation guideinterface 1323 configured to interface with actuation guide 245. In oneor more embodiments, piston tube 1325 may be fixed to actuationmechanism proximal end 1322. Illustratively, actuation mechanism 1320and piston tube 1325 may be manufactured as a unit. In one or moreembodiments, housing sleeve proximal end 252 may be fixed to noseconedistal end 241. Illustratively, actuation guide 245 may be fixed aninner portion of nosecone 240. In one or more embodiments, actuationguide 245, nosecone 240, and housing sleeve 250 may be manufactured as aunit.

FIGS. 14A and 14B are schematic diagrams illustrating an assembledactuation mechanism 1400. FIG. 14A illustrates a top view of anassembled actuation mechanism 1400. Illustratively, assembled actuationmechanism 1400 may comprise a pressure mechanism distal interface 1410.FIG. 14B illustrates a cross-sectional view of an assembled actuationmechanism 1400. In one or more embodiments, assembled actuationmechanism 1400 may comprise an actuation mechanism inner chamber 1420and a shape memory sleeve housing 1430.

FIGS. 15A and 15B are schematic diagrams illustrating an assembledsteerable laser probe 1500. FIG. 15A illustrates a side view of anassembled steerable laser probe 1500. Illustratively, optic fiber 270may be disposed within shape memory sleeve 260, e.g., optic fiber distalend 271 may be adjacent to shape memory sleeve distal end 261. Opticfiber 270 may be fixed in a position within shape memory sleeve 260,e.g., by a biocompatible adhesive or any other suitable fixation means.In one or more embodiments, shape memory sleeve 260 may comprise apre-bent angle 265 configured to curve optic fiber 270 towards pre-bentangle 265. Illustratively, shape memory sleeve 260 may comprise a shapememory material, e.g., nitinol, configured to steer optic fiber 270towards one or more surgical targets within an eye. Shape memory sleeve260 may be manufactured from any suitable material, e.g., polymers,metals, metal alloys, etc., or from any combination of suitablematerials.

FIG. 15B illustrates a cross-sectional view of an assembled steerablelaser probe 1500. Illustratively, pressure mechanism 1330 may bedisposed over piston tube 1325, e.g., pressure mechanism distal end 1331may abut pressure mechanism distal interface 1410. In one or moreembodiments, pressure mechanism 1330 may be configured to provide aforce. Illustratively, pressure mechanism 1330 may comprise a spring.Pressure mechanism 1330 may be manufactured from any suitable material,e.g., polymers, metals, metal alloys, etc., or from any combination ofsuitable materials.

Illustratively, actuation guide 245 may be disposed within actuationmechanism 1320 and piston tube 1325, e.g., actuation mechanism proximalend 247 may extend a distance from piston tube proximal end 1327. In oneor more embodiments, actuation guide interface 1323 may be configured tointerface with actuation guide 245, e.g., when actuation guide 245 isdisposed within actuation mechanism 1320, actuation guide interface 1323may be contained within actuation channel 310. Illustratively, pressuremechanism 1330 may be disposed between actuation mechanism 1320 andpressure mechanism proximal interface 1260, e.g., pressure mechanismproximal end 1332 may abut pressure mechanism proximal interface 1260and pressure mechanism distal end 1331 may abut pressure mechanismdistal interface 1410.

In one or more embodiments, actuation guide 245 may be disposed withininner bore 1240. Illustratively, piston tube 1325 and pressure mechanism1330 may be disposed within actuation structure 1220. In one or moreembodiments, a portion of actuation mechanism 1320 may be disposedwithin actuation structure 1220. Illustratively, optic fiber 270 andshape memory sleeve 260 may be disposed within inner bore 1240,actuation guide inner bore 320, piston tube 1325, actuation mechanism1320, shape memory sleeve housing 1430, housing sleeve guide 340, andhousing sleeve 250. In one or more embodiments, optic fiber 270 andshape memory sleeve 260 may be fixed to an inner portion of actuationmechanism 1320, e.g., optic fiber 270 and shape memory sleeve 260 may befixed within shape memory sleeve housing 1430. For example, shape memorysleeve 260 may be fixed within shape memory sleeve housing 1430 by anadhesive or by any suitable fixation means. Illustratively, an actuationof actuation mechanism 1320 may be configured to actuate optic fiber 270and shape memory sleeve 260.

In one or more embodiments, fixation mechanism 1310 may be configured tofix actuation guide 245 in a position relative to handle 1200. Forexample, fixation mechanism 1310 may comprise a set screw configured tofix actuation guide 245 in a position relative to handle 1200, e.g., byan interference fit in actuation channel 310. In one or moreembodiments, fixation mechanism 1310 may comprise an adhesive materialconfigured to fix actuation guide 245 in a position relative to handle1200, or fixation mechanism 1310 may comprise one or more magnetsconfigured to fix actuation guide 245 in a position relative to handle1200.

Illustratively, a compression of actuation structure 1220 may beconfigured to retract a portion of actuation mechanism 1320 intoactuation structure 1220. For example, a compression of actuationstructure 1220 may be configured to retract actuation mechanism 1320relative to handle proximal end 1202. In one or more embodiments, anapplication of a compressive force to one or more actuation arms 1225 ofactuation structure 1220 may be configured to retract actuationmechanism 1320 relative to handle proximal end 1202. For example, acompression of actuation structure 1220 may be configured to actuateactuation mechanism 1320 along actuation mechanism guide 245. In one ormore embodiments, a compression of actuation structure 1220 may beconfigured to retract actuation guide interface 1323 within actuationchannel 310, e.g., away from nosecone distal end 241 and towards handleproximal end 1202. Illustratively, pressure mechanism 1330 may beconfigured to provide a resistive force that resists a retraction ofactuation mechanism 1320 relative to handle proximal end 1202.

In one or more embodiments, a retraction of actuation mechanism 1320away from nosecone distal end 241 and towards handle proximal end 1202,e.g., due to a compression of actuation structure 1220, may beconfigured to retract optic fiber 270 and shape memory sleeve 260relative to housing sleeve 250. Illustratively, a compression ofactuation structure 1220 may be configured to actuate optic fiber 270and shape memory sleeve 260 relative to housing sleeve 250 wherein opticfiber 270 and shape memory sleeve 260 may be gradually retracted intohousing sleeve 250. In one or more embodiments, shape memory sleeve 260and optic fiber 270 may be gradually straightened as shape memory sleeve260 and optic fiber 270 are gradually retracted into housing sleeve 250.

Illustratively, a decompression of actuation structure 1220 may beconfigured to extend a portion of actuation mechanism 1320 fromactuation structure 1220. For example, a decompression of actuationstructure 1220 may be configured to extend actuation mechanism 1320relative to handle proximal end 1202. In one or more embodiments, areduction of a compressive force applied to one or more actuation arms1225 of actuation structure 1220 may be configured to extend actuationmechanism 1320 towards nosecone distal end 241 and away from handleproximal end 1202. For example, a decompression of actuation structure1220 may be configured to actuate actuation mechanism 1320 alongactuation mechanism guide 245. In one or more embodiments, adecompression of actuation structure 1220 may be configured to advanceactuation guide interface 1323 within actuation channel 310, e.g., awayfrom actuation guide proximal end 247 and towards nosecone distal end241. Illustratively, pressure mechanism 1330 may be configured toprovide a facilitating force that facilitates an extension of actuationmechanism 1320 relative to handle proximal end 1202.

In one or more embodiments, an extension of actuation mechanism 1320towards nosecone distal end 241 and away from handle proximal end 1202,e.g., due to a decompression of actuation structure 1220, may beconfigured to extend shape memory sleeve 260 and optic fiber 270relative to housing sleeve 250. Illustratively, a decompression ofactuation structure 1220 may be configured to actuate shape memorysleeve 260 and optic fiber 270 relative to housing sleeve 250 whereinshape memory sleeve 260 and optic fiber 270 may be gradually extendedfrom housing sleeve distal end 251. In one or more embodiments, shapememory sleeve 260 may be configured to gradually curve optic fiber 270,e.g., towards pre-bent angle 265, as shape memory sleeve 260 and opticfiber 270 are gradually extended from housing sleeve distal end 251.

FIGS. 16A, 16B, and 16C are schematic diagrams illustrating a gradualcurving of an optic fiber 270. FIG. 16A illustrates a straightened opticfiber 1600. Illustratively, straightened optic fiber 1600 may be fullycontained within housing sleeve 250. In one or more embodiments, opticfiber 270 and shape memory sleeve 260 may be fully contained withinhousing sleeve 250, e.g., when actuation structure 1220 is fullycompressed. For example, actuation mechanism 1320 may be fully retractedrelative to handle proximal end 1202, e.g., when optic fiber 270comprises a straightened optic fiber 1600. Illustratively, when opticfiber 270 and shape memory sleeve 260 are fully contained within housingsleeve 250, pre-bent angle 265 of shape memory sleeve 260 may bestraightened by housing sleeve 250. For example, an angle betweenhousing sleeve 250 and a line tangent to optic fiber distal end 271 maybe, e.g., 180 degrees, when housing sleeve 250 contains a straightenedoptic fiber 1600.

FIG. 16B illustrates a partially curved optic fiber 1610. In one or moreembodiments, a decompression of a fully compressed actuation structure1220 may be configured to gradually extend optic fiber 270 and shapememory sleeve 260 from housing sleeve distal end 251. Illustratively, asoptic fiber 270 and shape memory sleeve 260 are gradually extended fromhousing sleeve distal end 251, shape memory sleeve 260 may be configuredto cause optic fiber 270 to gradually curve toward pre-bent angle 265.In one or more embodiments, a decompression of actuation structure 1220may be configured to cause a straightened optic fiber 1600 to graduallycurve to a partially curved optic fiber 1610. Illustratively, adecompression of actuation structure 1220 may be configured to graduallyextend optic fiber 270 and shape memory sleeve 260 out of housing sleeve250 causing optic fiber 270 to gradually curve toward pre-bent angle265. For example, as an extended length of optic fiber 270 and shapememory sleeve 260 is increased, e.g., by a decompression of actuationstructure 1220, an angle between housing sleeve 250 and a line tangentto optic fiber distal end 271 may be decreased.

Illustratively, optic fiber 270 and shape memory sleeve 260 may beextended from housing sleeve distal end 251 at a first extended lengthwith a first angle between housing sleeve 250 and a line tangent tooptic fiber distal end 271. An extension of optic fiber 270 and shapememory sleeve 260 from housing sleeve distal end 251, e.g., due to adecompression of actuation structure 1220, may be configured to extendoptic fiber 270 and shape memory sleeve 260 from housing sleeve distalend 251 at a second extended length with a second angle between housingsleeve 250 and a line tangent to optic fiber distal end 271.Illustratively, the second extended length may be greater than the firstextended length and the second angle may be less than the first angle.

FIG. 16C illustrates a fully curved optic fiber 1620. Illustratively,when actuation mechanism 1320 is fully extended relative to handleproximal end 1202, e.g., due to a full decompression of actuationstructure 1220, a fully curved optic fiber 1620 may be extended fromhousing sleeve distal end 251. In one or more embodiments, adecompression of actuation structure 1220 may be configured to cause apartially curved optic fiber 1610 to gradually curve to a fully curvedoptic fiber 1620.

Illustratively, when actuation mechanism 1320 is extended relative tohandle proximal end 1202 to extend a partially curved optic fiber 1610from housing sleeve distal end 251, optic fiber 270 and shape memorysleeve 260 may be extended from housing sleeve distal end 251 at apartially extended length with a partially extended angle betweenhousing sleeve 250 and a line tangent to optic fiber distal end 271. Anextension of optic fiber 270 and shape memory sleeve 260 from housingsleeve distal end 251, e.g., due to a full decompression of actuationstructure 1220, may be configured to extend optic fiber 270 and shapememory sleeve 260 from housing sleeve distal end 251 at fully extendedlength with a fully extended angle between housing sleeve 250 and a linetangent to optic fiber distal end 271. For example, optic fiber 270 andshape memory sleeve 260 may extend from housing sleeve distal end 251 ata fully extended length with a fully extended angle between housingsleeve 250 and a line tangent to optic fiber distal end 271, e.g., whenoptic fiber 270 comprises a fully curved optic fiber 1620.Illustratively, the fully extended length may be greater than thepartially extended length and the fully extended angle may be less thanthe partially extended angle.

In one or more embodiments, one or more properties of a steerable laserprobe may be adjusted to attain one or more desired steerable laserprobe features. Illustratively, a position of fixation mechanism housing1250 and fixation mechanism 1310 or a length of optic fiber 270 andshape memory sleeve 260 extending distally from a position of fixationmechanism 1310 may be adjusted to vary an amount of decompression ofactuation structure 1220 configured to extend a particular length ofoptic fiber 270 and shape memory sleeve 260 from housing sleeve distalend 251. In one or more embodiments, one or more properties of pressuremechanism 1330 may be adjusted to attain one or more desired steerablelaser probe features. Illustratively, a spring constant of pressuremechanism 1330 may be adjusted to vary an amount of decompression ofactuation structure 1220 configured to extend a particular length ofoptic fiber 270 and shape memory sleeve 260 from housing sleeve distalend 251. In one or more embodiments, a geometry of actuation mechanism1320 may be adjusted to vary an amount of decompression of actuationstructure 1220 configured to extend a particular length of optic fiber270 and shape memory sleeve 260 from housing sleeve distal end 251.Illustratively, a length of housing sleeve 250 may be adjusted to varyan amount of decompression of actuation structure 1220 configured toextend a particular length of optic fiber 270 and shape memory sleeve260 from housing sleeve distal end 251. In one or more embodiments, ageometry of actuation structure 1220 may be adjusted to vary an amountof decompression of actuation structure 1220 configured to extend aparticular length of optic fiber 270 and shape memory sleeve 260 fromhousing sleeve distal end 251. Illustratively, a magnitude of pre-bentangle 265 may be adjusted to vary a magnitude of an angle betweenhousing sleeve 250 and a line tangent to optic fiber distal end 271 whena particular length of optic fiber 270 and shape memory sleeve 260 isextended from housing sleeve distal end 251.

In one or more embodiments, one or more properties of optic fiber 270may be adjusted to attain one or more steerable laser probe features.For example, a portion of optic fiber 270 may be formed in a pre-bentangle. Illustratively, a portion of optic fiber 270 may be formed in apre-bent angle by, e.g., heating the portion of optic fiber 270 to atemperature configured to weaken chemical bonds of the portion of opticfiber 270, molding the portion of optic fiber 270 in a pre-bent angle,and cooling the portion of optic fiber 270. In one or more embodiments,optic fiber 270 may be coated by a buffer material. Illustratively, thebuffer material may comprise a fluoropolymer, e.g., Teflon, Tefzel, etc.In one or more embodiments, a portion of optic fiber 270 may be formedin a pre-bent angle by, e.g., heating the buffer material to atemperature configured to weaken chemical bonds of the buffer material,molding the portion of optic fiber 270 in a pre-bent angle, and coolingthe buffer material. Illustratively, housing sleeve 250 may beconfigured to hold a pre-bent angle of optic fiber 270 in a straightenedposition, e.g., when optic fiber 270 is fully contained within housingsleeve 250. In one or more embodiments, a decompression of actuationstructure 1220 may be configured to extend optic fiber 270 relative tohousing sleeve 250 causing optic fiber 270 to gradually curve towardsthe pre-bent angle as optic fiber 270 is gradually extended from housingsleeve distal end 251.

FIGS. 17A, 17B, and 17C are schematic diagrams illustrating a gradualstraightening of an optic fiber 270. FIG. 17A illustrates an extendedoptic fiber 1700. Illustratively, actuation mechanism 1320 may beextended relative to handle proximal end 1202 to extend at least aportion of optic fiber 270 and shape memory sleeve 260, e.g., when opticfiber 270 comprises an extended optic fiber 1700. In one or moreembodiments, a full decompression of actuation structure 1220 may beconfigured to extend optic fiber 270 and shape memory sleeve 260relative to housing sleeve 250 wherein a fully curved optic fiber 1620may be extended from housing sleeve distal end 251. Illustratively,optic fiber 270 may comprise an extended optic fiber 1700, e.g., due toa full decompression of actuation structure 1220.

FIG. 17B illustrates a partially retracted optic fiber 1710.Illustratively, housing sleeve 250 may be configured to hold a portionof pre-bent angle 265 in a straightened position within housing sleeve250, e.g., when optic fiber 270 comprises a partially retracted opticfiber 1710. In one or more embodiments, a compression of actuationstructure 1220 may be configured to retract optic fiber 270 and shapememory sleeve 260 into housing sleeve 250 causing shape memory sleeve260 to gradually straighten optic fiber 270 from a fully curved opticfiber 1620 to a partially curved optic fiber 1610.

FIG. 17C illustrates a fully retracted optic fiber 1720. Illustratively,housing sleeve 250 may be configured to hold pre-bent angle 265 in astraightened position within housing sleeve 250, e.g., when optic fiber270 comprises a fully retracted optic fiber 1720. In one or moreembodiments, a full compression of actuation structure 1220 may beconfigured to retract optic fiber 270 and shape memory sleeve 260 intohousing sleeve 250 causing shape memory sleeve 260 to graduallystraighten optic fiber 270 from a partially curved optic fiber 1610 to astraightened optic fiber 1600.

Illustratively, a surgeon may aim optic fiber distal end 271 at any of aplurality of targets within an eye, e.g., to perform a photocoagulationprocedure. In one or more embodiments, a surgeon may aim optic fiberdistal end 271 at any target within a particular transverse plane of theinner eye by, e.g., rotating handle 1200 to orient shape memory sleeve260 in an orientation configured to cause a curvature of optic fiber 270within the particular transverse plane of the inner eye and varying anamount of compression of actuation structure 1220. Illustratively, asurgeon may aim optic fiber distal end 271 at any target within aparticular sagittal plane of the inner eye by, e.g., rotating handle1200 to orient shape memory sleeve 260 in an orientation configured tocause a curvature of optic fiber 270 within the particular sagittalplane of the inner eye and varying an amount of compression of actuationstructure 1220. In one or more embodiments, a surgeon may aim opticfiber distal end 271 at any target within a particular frontal plane ofthe inner eye by, e.g., varying an amount of compression of actuationstructure 1220 to orient a line tangent to optic fiber distal end 271wherein the line tangent to optic fiber distal end 271 is within theparticular frontal plane of the inner eye and rotating handle 1200.Illustratively, a surgeon may aim optic fiber distal end 271 at anytarget located outside of the particular transverse plane, theparticular sagittal plane, and the particular frontal plane of the innereye, e.g., by varying a rotational orientation of handle 1200 andvarying an amount of compression of actuation structure 1220.

FIGS. 18A and 18B are schematic diagrams illustrating a handle 1800.FIG. 18A illustrates a top view of handle 1800. In one or moreembodiments, handle 1800 may comprise a handle distal end 1801, a handleproximal end 1802, a handle base 1810, and an actuation structure 1820.Illustratively, actuation structure 1820 may comprise a plurality ofactuation arms 1825. In one or more embodiments, actuation structure1820 may comprise a shape memory material. Actuation structure 1820 maybe manufactured from any suitable material, e.g., polymers, metals,metal alloys, etc., or from any combination of suitable materials.

Illustratively, actuation structure 1820 may be compressed by anapplication of a compressive force to actuation structure 1820. In oneor more embodiments, actuation structure 1820 may be compressed by anapplication of one or more compressive forces located at one or morelocations around an outer perimeter of actuation structure 1820.Illustratively, the one or more locations may comprise any of aplurality of locations around the outer perimeter of actuation structure1820. For example, a surgeon may compress actuation structure 1820 bysqueezing actuation structure 1820. Illustratively, the surgeon maycompress actuation structure 1820 by squeezing actuation structure 1820at any particular location of a plurality of locations around an outerperimeter of actuation structure 1820. For example, a surgeon may rotatehandle 100 and compress actuation structure 1820 from any rotationalposition of a plurality of rotational positions of handle 1800.

In one or more embodiments, actuation structure 1820 may be compressedby an application of a compressive force to any one or more of theplurality of actuation arms 1825. Illustratively, each actuation arm1825 may be configured to actuate independently. In one or moreembodiments, each actuation arm 1825 may be connected to one or more ofthe plurality of actuation arms 1825 wherein an actuation of aparticular actuation arm 1825 may be configured to actuate everyactuation arm 1825 of the plurality of actuation arms 1825. In one ormore embodiments, a compression of actuation structure 1820, e.g., dueto an application of a compressive force to a particular actuation arm1825, may be configured to actuate the particular actuation arm 1825.Illustratively, an actuation of the particular actuation arm 1825 may beconfigured to actuate every actuation arm 1825 of the plurality ofactuation arms 1825.

FIG. 18B illustrates a cross-sectional view of handle 1800. In one ormore embodiments, handle 1800 may comprise an inner bore 1840, afixation mechanism housing 1850, and a pressure mechanism proximalinterface 1860. Handle 1800 may be manufactured from any suitablematerial, e.g., polymers, metals, metal alloys, etc., or from anycombination of suitable materials.

FIG. 19 illustrates an exploded view of a steerable laser probe assembly1900. In one or more embodiments, steerable laser probe assembly 1900may comprise a handle 1800, a fixation mechanism 1910, an actuationmechanism 1320 having an actuation mechanism distal end 1321 and anactuation mechanism proximal end 1322, a piston tube 1325 having apiston tube distal end 1326 and a piston tube proximal end 1327, apressure mechanism 1330 having a pressure mechanism distal end 1331 anda pressure mechanism proximal end 1332, a nosecone 240 having a noseconedistal end 241 and a nosecone proximal end 242, an actuation guide 245having an actuation guide proximal end 247, a housing sleeve 250 havinga housing sleeve distal end 251 and a housing sleeve proximal end 252, ashape memory sleeve 260 having a shape memory sleeve distal end 261 anda shape memory sleeve proximal end 262, an optic fiber 270 having anoptic fiber distal end 271 and an optic fiber proximal end 272, and alight source interface 280. Illustratively, light source interface 280may be configured to interface with optic fiber proximal end 272. In oneor more embodiments, light source interface 280 may comprise a standardlight source connecter, e.g., an SMA connector.

Illustratively, actuation mechanism 1320 may comprise an actuation guideinterface 1323 configured to interface with actuation guide 245. In oneor more embodiments, piston tube 1325 may be fixed to actuationmechanism proximal end 1322. Illustratively, housing sleeve 250 may befixed to actuation mechanism 1320, e.g., housing sleeve proximal end 252may be fixed to actuation mechanism distal end 1321. In one or moreembodiments, actuation mechanism 1320, piston tube 1325, and housingsleeve 250 may be manufactured as a unit. Illustratively, actuationguide 245 may be fixed an inner portion of nosecone 240. In one or moreembodiments, actuation guide 245, nosecone 240, and housing sleeve 250may be manufactured as a unit.

FIGS. 20A and 20B are schematic diagrams illustrating an assembledsteerable laser probe 2000. FIG. 20A illustrates a side view of anassembled steerable laser probe 2000. Illustratively, optic fiber 270may be disposed within shape memory sleeve 260, e.g., optic fiber distalend 271 may be adjacent to shape memory sleeve distal end 261. Opticfiber 270 may be fixed in a position within shape memory sleeve 260,e.g., by a biocompatible adhesive or any other suitable fixation means.In one or more embodiments, shape memory sleeve 260 may comprise apre-bent angle 265 configured to curve optic fiber 270 towards pre-bentangle 265. Illustratively, shape memory sleeve 260 may comprise a shapememory material, e.g., nitinol, configured to steer optic fiber 270towards one or more surgical targets within an eye. Shape memory sleeve260 may be manufactured from any suitable material, e.g., polymers,metals, metal alloys, etc., or from any combination of suitablematerials.

FIG. 20B illustrates a cross-sectional view of an assembled steerablelaser probe 2000. Illustratively, pressure mechanism 1330 may bedisposed over piston tube 1325, e.g., pressure mechanism distal end 1331may abut pressure mechanism distal interface 1410. In one or moreembodiments, pressure mechanism 1330 may be configured to provide aforce. Illustratively, pressure mechanism 1330 may comprise a spring.Pressure mechanism 1330 may be manufactured from any suitable material,e.g., polymers, metals, metal alloys, etc., or from any combination ofsuitable materials.

In one or more embodiments, housing sleeve 250 may be disposed withinactuation guide 245, nosecone 240, and housing sleeve guide 340, e.g.,housing sleeve distal end 251 may extend a distance from nosecone distalend 241. Illustratively, actuation guide 245 may be disposed withinactuation mechanism 1320 and piston tube 1325, e.g., actuation mechanismproximal end 247 may extend a distance from piston tube proximal end1327. In one or more embodiments, actuation guide interface 1323 may beconfigured to interface with actuation guide 245, e.g., when actuationguide 245 is disposed within actuation mechanism 1320, actuation guideinterface 1323 may be contained within actuation channel 310.Illustratively, pressure mechanism 1330 may be disposed betweenactuation mechanism 1320 and pressure mechanism proximal interface 1860,e.g., pressure mechanism proximal end 1332 may abut pressure mechanismproximal interface 1860 and pressure mechanism distal end 1331 may abutpressure mechanism distal interface 1410.

In one or more embodiments, actuation guide 245 may be disposed withininner bore 1840. Illustratively, piston tube 1325 and pressure mechanism1330 may be disposed within actuation structure 1820. In one or moreembodiments, a portion of actuation mechanism 1320 may be disposedwithin actuation structure 1820. Illustratively, optic fiber 270 andshape memory sleeve 260 may be disposed within inner bore 1840,actuation guide inner bore 320, piston tube 1325, actuation mechanism1320, housing sleeve guide 340, and housing sleeve 250.

In one or more embodiments, fixation mechanism 1910 may be configured tofix optic fiber 270, shape memory sleeve 260, and actuation guide 245 ina position relative to handle 1800. For example, fixation mechanism 1910may comprise a set screw configured to fix optic fiber 270, shape memorysleeve 260, and actuation guide 245 in a position relative to handle1800, e.g., by an interference fit in actuation channel 310. In one ormore embodiments, fixation mechanism 1910 may comprise an adhesivematerial configured to fix optic fiber 270, shape memory sleeve 260, andactuation guide 245 in a position relative to handle 1800, or fixationmechanism 1910 may comprise one or more magnets configured to fix opticfiber 270, shape memory sleeve 260, and actuation guide 245 in aposition relative to handle 1800.

Illustratively, a compression of actuation structure 1820 may beconfigured to retract a portion of actuation mechanism 1320 intoactuation structure 1820. For example, a compression of actuationstructure 1820 may be configured to retract actuation mechanism 1320relative to handle proximal end 1802. In one or more embodiments, anapplication of a compressive force to one or more actuation arms 1825 ofactuation structure 1820 may be configured to retract actuationmechanism 1320 relative to handle proximal end 1802. For example, acompression of actuation structure 1820 may be configured to actuateactuation mechanism 1320 along actuation mechanism guide 245. In one ormore embodiments, a compression of actuation structure 1820 may beconfigured to retract actuation guide interface 1323 within actuationchannel 310, e.g., away from nosecone distal end 241 and towards handleproximal end 1802. Illustratively, pressure mechanism 1330 may beconfigured to provide a resistive force that resists a retraction ofactuation mechanism 1320 relative to handle proximal end 1802.

In one or more embodiments, a retraction of actuation mechanism 1320away from nosecone distal end 241 and towards handle proximal end 1802,e.g., due to a compression of actuation structure 1820, may beconfigured to retract housing sleeve 250 relative to optic fiber 270 andshape memory sleeve 260. Illustratively, a compression of actuationstructure 1820 may be configured to actuate housing sleeve 250 relativeto optic fiber 270 and shape memory sleeve 260 wherein optic fiber 270and shape memory sleeve 260 may be gradually exposed by housing sleeve250. In one or more embodiments, shape memory sleeve 260 may beconfigured to gradually curve optic fiber 270, e.g., towards pre-bentangle 265, as shape memory sleeve 260 and optic fiber 270 are graduallyexposed by housing sleeve 250.

Illustratively, a decompression of actuation structure 1820 may beconfigured to extend a portion of actuation mechanism 1320 fromactuation structure 1820. For example, a decompression of actuationstructure 1820 may be configured to extend actuation mechanism 1320relative to handle proximal end 1802. In one or more embodiments, areduction of a compressive force applied to one or more actuation arms1825 of actuation structure 1820 may be configured to extend actuationmechanism 1320 towards nosecone distal end 241 and away from handleproximal end 1802. For example, a decompression of actuation structure1820 may be configured to actuate actuation mechanism 1320 alongactuation mechanism guide 245. In one or more embodiments, adecompression of actuation structure 1820 may be configured to advanceactuation guide interface 1323 within actuation channel 310, e.g., awayfrom actuation guide proximal end 247 and towards nosecone distal end241. Illustratively, pressure mechanism 1330 may be configured toprovide a facilitating force that facilitates an extension of actuationmechanism 1320 relative to handle proximal end 1802.

In one or more embodiments, an extension of actuation mechanism 1320towards nosecone distal end 241 and away from handle proximal end 1802,e.g., due to a decompression of actuation structure 1220, may beconfigured to extend housing sleeve 250 relative to shape memory sleeve260 and optic fiber 270. Illustratively, a decompression of actuationstructure 1820 may be configured to actuate housing sleeve 250 relativeto shape memory sleeve 260 and optic fiber 270 wherein housing sleeve250 may be gradually extended over shape memory sleeve 260 and opticfiber 270. In one or more embodiments, shape memory sleeve 260 and opticfiber 270 may be gradually straightened as housing sleeve 250 isgradually extended over shape memory sleeve 260 and optic fiber 270.

FIGS. 21A, 21B, and 21C are schematic diagrams illustrating a gradualcurving of an optic fiber 270. FIG. 21A illustrates a straightened opticfiber 2100. Illustratively, straightened optic fiber 2100 may be fullycontained within housing sleeve 250. In one or more embodiments, opticfiber 270 and shape memory sleeve 260 may be fully contained withinhousing sleeve 250, e.g., when actuation structure 1820 is fullydecompressed. For example, actuation mechanism 1320 may be fullyextended relative to handle proximal end 1802, e.g., when optic fiber270 comprises a straightened optic fiber 2100. Illustratively, whenoptic fiber 270 and shape memory sleeve 260 are fully contained withinhousing sleeve 250, pre-bent angle 265 of shape memory sleeve 260 may bestraightened by housing sleeve 250. For example, an angle betweenhousing sleeve 250 and a line tangent to optic fiber distal end 271 maybe, e.g., 180 degrees, when housing sleeve 250 contains a straightenedoptic fiber 2100.

FIG. 21B illustrates a partially curved optic fiber 2110. In one or moreembodiments, a compression of a fully decompressed actuation structure1820 may be configured to gradually retract housing sleeve 250, e.g., toexpose optic fiber 270 and shape memory sleeve 260. Illustratively, asoptic fiber 270 and shape memory sleeve 260 are gradually exposed by aretraction of housing sleeve 250, shape memory sleeve 260 may beconfigured to cause optic fiber 270 to gradually curve toward pre-bentangle 265. In one or more embodiments, a compression of actuationstructure 1820 may be configured to cause a straightened optic fiber2100 to gradually curve to a partially curved optic fiber 2110.Illustratively, a compression of actuation structure 1820 may beconfigured to gradually expose optic fiber 270 and shape memory sleeve260 causing optic fiber 270 to gradually curve toward pre-bent angle265. For example, as an exposed length of optic fiber 270 and shapememory sleeve 260 is increased, e.g., by a retraction of housing sleeve250, an angle between housing sleeve 250 and a line tangent to opticfiber distal end 271 may be decreased.

Illustratively, optic fiber 270 and shape memory sleeve 260 may beexposed from housing sleeve distal end 251 at a first exposed lengthwith a first angle between housing sleeve 250 and a line tangent tooptic fiber distal end 271. A retraction of housing sleeve 250, e.g.,due to a compression of actuation structure 1820, may be configured toexpose optic fiber 270 and shape memory sleeve 260 from housing sleevedistal end 251 at a second exposed length with a second angle betweenhousing sleeve 250 and a line tangent to optic fiber distal end 271.Illustratively, the second exposed length may be greater than the firstexposed length and the second angle may be less than the first angle.

FIG. 21C illustrates a fully curved optic fiber 2120. Illustratively,when housing sleeve 250 is fully retracted, e.g., by a full compressionof actuation structure 1820, housing sleeve 250 may expose a fullycurved optic fiber 2120. In one or more embodiments, a compression ofactuation structure 1820 may be configured to cause a partially curvedoptic fiber 2110 to gradually curve to a fully curved optic fiber 2120.

Illustratively, when housing sleeve 250 is retracted to expose apartially curved optic fiber 2110, optic fiber 270 and shape memorysleeve 260 may be exposed from housing sleeve distal end 251 at apartially exposed length with a partially exposed angle between housingsleeve 250 and a line tangent to optic fiber distal end 271. Aretraction of housing sleeve 250, e.g., due to a full compression ofactuation structure 1820, may be configured to expose optic fiber 270and shape memory sleeve 260 from housing sleeve distal end 251 at fullyexposed length with a fully exposed angle between housing sleeve 250 anda line tangent to optic fiber distal end 271. For example, housingsleeve 250 may expose optic fiber 270 and shape memory sleeve 260 at afully exposed length with a fully exposed angle between housing sleeve250 and a line tangent to optic fiber distal end 271 when housing sleeve250 is retracted to expose a fully curved optic fiber 2120.Illustratively, the fully exposed length may be greater than thepartially exposed length and the fully exposed angle may be less thanthe partially exposed angle.

In one or more embodiments, one or more properties of a steerable laserprobe may be adjusted to attain one or more desired steerable laserprobe features. Illustratively, a position of fixation mechanism housing1850 and fixation mechanism 1910 or a length of optic fiber 270 andshape memory sleeve 260 extending distally from a position of fixationmechanism 1910 may be adjusted to vary an amount of compression ofactuation structure 1820 configured to expose a particular length ofoptic fiber 270 and shape memory sleeve 260 from housing sleeve distalend 251. In one or more embodiments, one or more properties of pressuremechanism 1330 may be adjusted to attain one or more desired steerablelaser probe features. Illustratively, a spring constant of pressuremechanism 1330 may be adjusted to vary an amount of compression ofactuation structure 1820 configured to expose a particular length ofoptic fiber 270 and shape memory sleeve 260 from housing sleeve distalend 251. In one or more embodiments, a geometry of actuation mechanism1320 may be adjusted to vary an amount of compression of actuationstructure 1820 configured to expose a particular length of optic fiber270 and shape memory sleeve 260 from housing sleeve distal end 251.Illustratively, a length of housing sleeve 250 may be adjusted to varyan amount of compression of actuation structure 1820 configured toexpose a particular length of optic fiber 270 and shape memory sleeve260 from housing sleeve distal end 251. In one or more embodiments, ageometry of actuation structure 1820 may be adjusted to vary an amountof compression of actuation structure 1820 configured to expose aparticular length of optic fiber 270 and shape memory sleeve 260 fromhousing sleeve distal end 251. Illustratively, a magnitude of pre-bentangle 265 may be adjusted to vary a magnitude of an angle betweenhousing sleeve 250 and a line tangent to optic fiber distal end 271 whena particular length of optic fiber 270 and shape memory sleeve 260 isexposed from housing sleeve distal end 251.

In one or more embodiments, one or more properties of optic fiber 270may be adjusted to attain one or more steerable laser probe features.For example, a portion of optic fiber 270 may be formed in a pre-bentangle. Illustratively, a portion of optic fiber 270 may be formed in apre-bent angle by, e.g., heating the portion of optic fiber 270 to atemperature configured to weaken chemical bonds of the portion of opticfiber 270, molding the portion of optic fiber 270 in a pre-bent angle,and cooling the portion of optic fiber 270. In one or more embodiments,optic fiber 270 may be coated by a buffer material. Illustratively, thebuffer material may comprise a fluoropolymer, e.g., Teflon, Tefzel, etc.In one or more embodiments, a portion of optic fiber 270 may be formedin a pre-bent angle by, e.g., heating the buffer material to atemperature configured to weaken chemical bonds of the buffer material,molding the portion of optic fiber 270 in a pre-bent angle, and coolingthe buffer material. Illustratively, housing sleeve 250 may beconfigured to hold a pre-bent angle of optic fiber 270 in a straightenedposition, e.g., when optic fiber 270 is fully contained within housingsleeve 250. In one or more embodiments, a compression of actuationstructure 1820 may be configured to retract housing sleeve 250 relativeto optic fiber 270 causing optic fiber 270 to gradually curve towardsthe pre-bent angle as optic fiber 270 is gradually exposed by housingsleeve 250.

FIGS. 22A, 22B, and 22C are schematic diagrams illustrating a gradualstraightening of an optic fiber 270. FIG. 22A illustrates a retractedhousing sleeve 2200. Illustratively, a retracted housing sleeve 2200 mayexpose at least a portion of optic fiber 270 and shape memory sleeve 260from housing sleeve distal end 251. In one or more embodiments, a fullcompression of actuation structure 1820 may be configured to causehousing sleeve 250 to be retracted relative to optic fiber 270 and shapememory sleeve 260 wherein a fully curved optic fiber 2120 may be exposedfrom housing sleeve distal end 251. Illustratively, housing sleeve 250may comprise a retracted housing sleeve 2200, e.g., due to a fullcompression of actuation structure 1820.

FIG. 22B illustrates a partially extended housing sleeve 2210.Illustratively, a partially extended housing sleeve 2210 may hold aportion of pre-bent angle 265 in a straightened position within housingsleeve 250. In one or more embodiments, a decompression of actuationstructure 1820 may be configured to extend housing sleeve 250 over opticfiber 270 and shape memory sleeve 260 causing shape memory sleeve 260 togradually straighten optic fiber 270 from a fully curved optic fiber2120 to a partially curved optic fiber 2110.

FIG. 22C illustrates a fully extended housing sleeve 2220.Illustratively, a fully extended housing sleeve 2220 may hold pre-bentangle 265 in a straightened position within housing sleeve 250. In oneor more embodiments, a full decompression of actuation structure 1820may be configured to extend housing sleeve 250 over optic fiber 270 andshape memory sleeve 260 causing shape memory sleeve 260 to graduallystraighten optic fiber 270 from a partially curved optic fiber 2110 to astraightened optic fiber 2100.

Illustratively, a surgeon may aim optic fiber distal end 271 at any of aplurality of targets within an eye, e.g., to perform a photocoagulationprocedure. In one or more embodiments, a surgeon may aim optic fiberdistal end 271 at any target within a particular transverse plane of theinner eye by, e.g., rotating handle 1800 to orient shape memory sleeve260 in an orientation configured to cause a curvature of optic fiber 270within the particular transverse plane of the inner eye and varying anamount of compression of actuation structure 1820. Illustratively, asurgeon may aim optic fiber distal end 271 at any target within aparticular sagittal plane of the inner eye by, e.g., rotating handle1800 to orient shape memory sleeve 260 in an orientation configured tocause a curvature of optic fiber 270 within the particular sagittalplane of the inner eye and varying an amount of compression of actuationstructure 1820. In one or more embodiments, a surgeon may aim opticfiber distal end 271 at any target within a particular frontal plane ofthe inner eye by, e.g., varying an amount of compression of actuationstructure 1820 to orient a line tangent to optic fiber distal end 271wherein the line tangent to optic fiber distal end 271 is within theparticular frontal plane of the inner eye and rotating handle 1800.Illustratively, a surgeon may aim optic fiber distal end 271 at anytarget located outside of the particular transverse plane, theparticular sagittal plane, and the particular frontal plane of the innereye, e.g., by varying a rotational orientation of handle 1800 andvarying an amount of compression of actuation structure 1820.

The foregoing description has been directed to particular embodiments ofthis invention. It will be apparent; however, that other variations andmodifications may be made to the described embodiments, with theattainment of some or all of their advantages. Specifically, it shouldbe noted that the principles of the present invention may be implementedin any probe system. Furthermore, while this description has beenwritten in terms of a surgical instrument handle for selectivelyactuating a shape memory sleeve and an optic fiber relative to a housingsleeve and for selectively actuating a housing sleeve relative to ashape memory sleeve and an optic fiber, the teachings of the presentinvention are equally suitable to systems where the functionality ofactuation may be employed. Therefore, it is the object of the appendedclaims to cover all such variations and modifications as come within thetrue spirit and scope of the invention.

What is claimed is:
 1. A method comprising: compressing an actuationstructure of a handle wherein the actuation structure has a plurality ofactuation arms and wherein the handle has a handle distal end and ahandle proximal end; extending an actuation mechanism of the handlerelative to the handle proximal end; advancing the actuation mechanismtowards an actuation mechanism distal interface; actuating the actuationmechanism along an actuation mechanism guide of the handle; advancing anactuation guide interface within an actuation channel of the handle;extending a shape memory sleeve relative to a housing sleeve wherein thehousing sleeve has a housing sleeve distal end and a housing sleeveproximal end; extending an optic fiber relative to the housing sleevewherein the optic fiber has an optic fiber distal end and an optic fiberproximal end and wherein the optic fiber distal end is adjacent to ashape memory sleeve distal end; and curving the optic fiber.
 2. Themethod of claim 1 wherein the shape memory sleeve is manufactured fromnitinol.
 3. The method of claim 1 wherein the shape memory sleeve has apre-bent angle.
 4. The method of claim 1 further comprising: using laserphotocoagulation to treat proliferative retinopathy.
 5. The method ofclaim 1 further comprising: energizing a laser.
 6. The method of claim 1further comprising: cauterizing one or more portions of a retina.
 7. Themethod of claim 1 further comprising: extending a portion of theactuation mechanism out of the actuation structure.
 8. The method ofclaim 1 further comprising: extending the optic fiber from the housingsleeve distal end.
 9. The method of claim 1 further comprising:extending the shape memory sleeve from the housing sleeve distal end.10. The method of claim 1 further comprising: providing a forceconfigured to resist an extension of the actuation mechanism relative tothe handle proximal end.
 11. The method of claim 1 further comprising:decompressing the actuation structure.
 12. The method of claim 1 furthercomprising: retracting a portion of the actuation mechanism into theactuation structure.
 13. The method of claim 1 further comprising:retracting the actuation mechanism relative to the handle proximal end.14. The method of claim 1 further comprising: retracting the actuationmechanism away from the actuation mechanism distal interface.
 15. Themethod of claim 1 further comprising: providing a force configured tofacilitate a retraction of the actuation mechanism relative to thehandle proximal end.
 16. The method of claim 1 further comprising:retracting the shape memory sleeve relative to the housing sleeve. 17.The method of claim 1 further comprising: retracting the optic fiberrelative to the housing sleeve.
 18. The method of claim 1 furthercomprising: retracting the shape memory sleeve into the housing sleeve.19. The method of claim 1 further comprising: retracting the optic fiberinto the housing sleeve.
 20. The method of claim 1 further comprising:straightening the optic fiber.